**Abstract**

The musical practice is an extremely complex activity that involves a series of cognitive abilities and functions, among them are hearing, memory, motor coordination, attention, affection, mathematical calculation, and the association of all of these concomitantly, including situations of public exposure. Because of this, musical performance is particularly susceptive to anxiety symptoms. Musical performance anxiety (MPA) is defined as an experience of persistent and distressing apprehension and/or real prejudice of the performance abilities in a public context in an unjustifiable degree given the individual musical aptitude and preparation level. It prevails more commonly on the female gender in a 3:1 proportion and affects about 20% of the professional musicians. In the present chapter, its main etiologies and psychic mechanisms, evaluation instruments, as well as the current therapeutic strategies available will be presented.

**Keywords:** performance anxiety, musical performance anxiety, musicians, perceived causes, psychological intervention, drug therapies, optimal performance

### **1. Introduction**

The musical practice is an extremely complex activity that involves a series of cognitive abilities and functions, among them are hearing, memory, motor coordination, attention, affection, mathematical calculation, and the association of all of these concomitantly, including situations of public exposure [1]. Because of this, musical performance is particularly susceptive to anxiety symptoms.

Anxiety in itself is, up to a certain point, something favorable to the performance [2], since it helps the performer to perceive what favors him and disregard what could hinder his performance. After a certain point, anxiety starts to influence negatively the musical performance efficiency, according to the Yerkes-Dodson curve (**Figure 1**).

Musical performance anxiety (MPA) is a term that encompasses many dimensions and started being described in 1990. It is the experience of a persistent and distressing apprehension and/or real prejudice of the performance abilities in a public context in an unjustifiable degree given the individual musical aptitude and preparation level [3].

In the musical environment, MPA has been called as "stage fright" although MPA encompasses something much bigger than that [4]. The reason is that MPA has three axes that complement each other in terms of subjective manifestations of this picture.

**Figure 1.** *The Yerkes-Dodson curve.*

Performance anxiety affects equally music professional and students. There is a prevalence of around 18% [5]. The main reported symptoms are concentration decrease, tachycardia, tremor, sweating, and xerostomia, which are severe enough to negatively impact on the performance level [5, 6].

In the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, or DSM-5, social anxiety disorder (SAD) is highlighted, in which the subject feels fear or anxiety in social interaction situations when he worries about the possibility of coming to be evaluated by the public [4].

In the present chapter, general aspects of MPA, its possible etiologies, its occurrence in the diverse age groups, the instruments of evaluation, and, at last, the therapeutic approaches will be approached.
